ME/CFS specialist Dr. Paul Cheney reports he has documented food sensitivities in roughly 50% of cases of Chronic Fatigue Syndrome, says Clinical Nutritionist Blake Graham. And a large proportion of Fibromyalgia patients suffer from food intolerances, though many do not know it.
Graham believes an elimination diet is the best method of assessing food sensitivities, and has developed this protocol for patients with chronic illnesses that includes a preliminary step for ME/CFS and fibromyalgia patients specifically. The protocol requires time and food label detective work. But it will produce great benefits for those who identify one or more diet troublemakers.
There are many reasons why individuals react negatively to foods, and laboratory assessment methods test only for specific mechanisms of reaction and exclude others (such as IgG).**
An elimination diet, by contrast, is not reliant on a particular mechanism, covers all food reactions, and is the best method of assessing food sensitivities.
The elimination diet described below is:
• Limited to unrefined/whole/fresh foods
• Devoid of food additives/colorings/artificial sugars
• Gluten free, casein free, and lactose free
• Very low in salicylates
• Very low in dietary yeasts
• Very low in dietary glutamates
• Very low in dietary biogenic amines
• Very low in dietary solanines
• Generally hypoallergenic
• Devoid of caffeine and alcohol.
Adhering to the following diet for a period of time enables a person to determine if any of these key, and common, food sensitivities are present. Observing benefits in any aspect of health while on this diet indicates one or more of the points listed above are significantly related to your symptoms.
This diet provides a snapshot in time of what you may feel like while taking into consideration all the factors listed above.
ELIMINATION DIET PROTOCOL
CFS/FM Patients – First, Go Gluten & Casein Free For 30 Days
In the weeks before an elimination diet, eat a nutrient-rich, unrefined and varied diet. In the case of Chronic Fatigue Syndrome, this diet trial should come after a gluten- and casein-free diet trial of 30 days or more. Sources of these two dietary proteins are explained below. Sensitivity to gluten and casein can sometimes take a more extended time period to become evident than a standard elimination diet allows.
To attempt this diet you must carefully read the ingredients list of every food you eat, and truly do it 100 percent, to see real results. No lab test negates the need for this trial. Most people who react negatively to gluten do not have true celiac disease (and therefore test negative to celiac blood tests), but rather another form of gluten sensitivity.
Sources of gluten include:
• Anything containing wheat, barley, rye, oats & spelt [a species of wheat grown in parts of Europe since ancient times, and now often a ‘health food’].
• Anything that contains the words gluten, gliadin & glutenin.
• Foods which state they may contain traces of wheat/gluten.
• Maltodextrin/malt (unless it states it is derived from rice or corn).
• Soy sauce (unless it states it is gluten free).
• Bran (unless it states it is gluten free and/or derived from rice or corn).
• Hydrolyzed vegetable protein (HVP).
• Bulgur, couscous, durum, dinkle, kamut, semolina & triticale [all AKA wheat].
Sources of casein include:
• Anything containing milk, yoghurt, cheese, butter, cream, icecream, goat’s milk derived products, etc.
• Milk solids.
• Anything that says casein or caseinate.
Choose the most convenient time to try this diet. For example not when relatives are staying over or when traveling. Ask for the support of your family.
First 7 to 10 Days Very Limited
For 7 to 10 days, consume nothing but the foods listed below. If there are any foods on this list you know or suspect you may be sensitive to, eliminate these foods also. (Aspirin should also be avoided during this period due to its high salicylate content.) Consume a varied diet, eating some [of these] fruits, vegetables, meats, and grains daily.
GRAINS – Whole grain rice (rinse before cooking)
MEAT – All unrefined (non aged/processed/smoked/seasoned) fresh meats, except beef
VEGETABLES – Cabbage, celery, green beans, iceberg lettuce, & swedes [rutabagas]
FRUITS – Peeled pears
OILS/SEASONINGS – Olive oil & sea salt
DRINKS – Water (filtered)
Keep a diary of symptoms and note any changes.
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• If symptoms worsen (or new symptoms appear) in the first 2 to 4 days, this may indicate withdrawal from food allergy or addiction.
• If after 7 to 10 days symptoms have improved, this may indicate food sensitivities of some kind.
Add Back Food Categories One at a Time
Add back foods one at a time and in a pure form (fresh corn, for example), or with a non-eliminated food, taking note of symptoms changes. Consume plenty of the foods you are testing. (Corn at lunch and dinner, for example.)
The following order for adding foods back is recommended:
1. Dairy (in the form of whole cream or plain yogurt)
3. Yeast [see below]
Allow about 48 hours between adding new foods.
Note changes in symptoms upon adding back foods [see list of “Common food allergy and intolerance symptoms/signs” below].
Any foods you react to should be eliminated, as you go on to test others. If you react to specific foods wait until the resulting symptoms have cleared before adding new foods.
Patterns to Look Out For
Some people are sensitive to dietary salicylates. [Found in many fruits and vegetables, often concentrated just under the skin and in the outer leaves of vegetables, such as cabbage and lettuce. Levels decrease as fruit/vegetable ripens. Discard outer leaves; peel thickly; go for ripe. For information on the relative salicylate levels of scores of fruits and vegetables, nuts and snacks, sweets, herbs/spices/condiments, coffees/teas, alcoholic beverages, and fats & oils, go to http://salicylatesensitivity.com/about/food-guide/]
Some people are sensitive to dietary yeasts. [Found in many foods including yeast raised breads; fermented beverages; vinegar; fruits eaten with skin, from berries, cherries, and grapes to prunes and raisins; olives; peanut butter. To print out a small chart of “permitted” and “not permitted” foods in a yeast-free diet, go to http://www.Nutritional-Healing.com.au/content/Yeast%20free%20diet.pdf]
Some people are sensitive to dietary glutamates. Glutamates are contained in MSG, hydrolyzed vegetable protein, anything that contains the word glutamic or glutamate, and foods including roquefort cheese, parmesan cheese, soy sauce, walnuts, fresh tomato juice, grape juice, peas, etc. [For more on foods containing glutamates, and other names for glutamates used in labeling, see "List of Foods Containing Glutamates." As this article notes, the soy protein used in so many prepared foods contains high amounts of glutamates, peanuts are high in glutamate, and the artificial sweetener Aspartame converts to glutamate in the digestive system.]
Some people are sensitive to dietary amines. Amines are contained in chocolate, cheese, fish, aged/processed meats, bananas, oranges, avocados, tomatoes, wine/beer, etc. [For a more complete food list with relative amine content levels, see "Amine Content of Foods]
Some people are sensitive to solanine containing foods. Solanines are contained in tomatoes, potatoes, peppers, eggplant. [They function as the plant’s natural defense against pests and fungus.]
Common Food Allergy and Intolerance Symptoms/Signs
• Increased mucus production in throat, regularly clearing throat, coughing
• Irregular flattened patches on tongue or mottled tongue
• Dark areas and/or blue, black or pink circles around eyes
• Nose rubbing/Itchy nose
• Nasal/sinus congestion or postnasal drip
• Headache, migraine
• Puffy eyes, nose, face
• Abnormally red cheeks/nose and/or flushed appearance
• Ears turn red for no apparent reason
• Inner corners of eyes itch
• Skin problems (eczema, rash or pale ring around mouth, dermatitis, itching, ‘burning’ feeling of skin, ‘creepy crawlies’ under skin feeling, numb skin, etc.)
• Diarrhea or loose stools or constipation
• Abdominal pains, bloating or nausea after meals
• Increased frequency of stools
• Feel/act best when don’t eat
• Strong particular food likes (cravings) and dislikes
• Unexplained intermittent +/- sudden irritability, depression, hyperactivity, anxiety, anger, crying, giggling, hiding in dark places, rage, vulgarity, not wanting to be touched
• Unexplained intermittent +/- sudden changes in walking, reading, writing, speaking
* Blake Graham specializes in nutritional and environmental treatments for patients with CFS, FM, and other chronic conditions. He is an associate of the Australasian College of Nutritional and Environmental Medicine in Perth, Western Australia (AACNEM). This article is reproduced with permission from his website Nutritional-Healing.com.au
** [For example, IgG-specific antibody tests look for the immunoglobulin G antibodies associated with non-atopic or ‘delayed’ food reactions to specific foods that can worsen or contribute to many different health problems. These tend to be frequently eaten foods that are hard to avoid, including milk, corn, and wheat. Another type of test – the IgE antibody assay – addresses less frequent but more immediate, high-profile atopic food sensitivities, such as those to peanuts or shellfish.]
Note: This information has not been evaluated by the FDA. It is not intended to diagnose, cure, treat, or prevent any illness, disease, or condition. Importantly, you should never make any change in your health care plan or health support regimen without researching and discussing it in consultation with your professional healthcare team.